This application is submitted in response to PA-02-043 ("Social and Cultural Dimensions of Health") to pursue research that moves beyond the simple description of health care disparities toward a scientific agenda that investigates the mechanisms and processes that help to explain these inequities. The research takes the innovative approach of examining tenets of "cognitive consensus" theory from the industrial/organizational literature on team functioning as they relate to clinical teamwork in mental health treatment for youth. The project will select a sample of 260 African American, Asian American/Pacific Islander, Latino, and non-Hispanic White adolescent clients entering services in a real-world setting of school-based mental health services. Cognitive consensus on key cognitive model components in adolescent-parent-therapist sets will be assessed at treatment entry, and the relationship between cognitive consensus and longitudinal service use, adolescent client satisfaction, and treatment outcomes will be examined. The specific aims of the study are to: (1) Describe how social, psychological, and contextual factors are associated with cognitive consensus; (2) Examine racial/ethnic differences in cognitive consensus; (3) Examine cognitive consensus as a predictor of service use, adolescent client satisfaction, and treatment outcomes. The proposed research is designed to identify factors evident in the initial clinical encounter that are associated with better treatment outcomes for an ethnically-diverse sample of youth. The ultimate goal of the proposed project is to increase the effectiveness of care by identifying specific culture-linked cognitive processes that can be targeted in future intervention development.